Forms & publications

Notice: If you are a biller or provider, visit our Billers and Providers forms library.

Administrative hearing request - DSHS Classic Medicaid

Complete this form to request an administrative hearing for DSHS Classic Medicaid.

Administrative hearing request – HCA/HBE

Use this form to request a hearing before a judge. Mail this form within 90 calendar days of the date on eligibility notice you disagree with. You may be able to keep Apple Health coverage during the hearing process if you request a hearing in less than 10 days.

Administrative hearing rights and deadlines - DSHS Classic Medicaid

This document provides information on your rights and the deadlines associated with administrative hearings. For DSHS Classic Medicaid clients.

AEM FAQ

Frequently asked questions about the Alien Emergency Medical (AEM) program.